4 Common Pickleball Injuries And How To Prevent Them

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Pickleball is the fastest-growing sport in the United States. As popularity grows, it’s important to learn injury prevention through exercise.Photo credit: bhpix / Shutterstock.com

What does an aging tennis player do when defending their 1,404 square feet of playing space is no longer effective? They join their fellow baby boomers and switch to the game of pickleball. Do a quick internet search and you’ll find pickleball being touted as the fastest growing sport in America.

A cross between tennis, badminton, and ping-pong, the game’s pace still offers a great workout, but instead of power serves and blistering volleys dominating the game, skill prevails. Its popularity comes from the fact that a wide range of age groups find it fun, it can be learned quickly, the court is smaller — just 484 square feet — and it’s normally played as doubles so there’s a huge social aspect to the game.

I’m not going to cover the details on how to play the game or the best equipment. What I’m going to focus on is how to keep yourself from sustaining an injury while you’re playing the game.

Pickleball is similar to other racket sports in that you’re moving about the court and hitting a ball with a paddle. That means injuries will be similar to what you see in tennis, racquetball, or badminton. However, taking a few precautions and adding some evidence-based practices can do a lot to help prevent injuries. My first recommendation is to invest in a good pair of court shoes right away to minimize the torque and twisting on the knees. A proper court shoe will give the proper grip to help prevent ankle or knee twists.

The 4 Most Common Types Of Pickleball Injuries

“Pickleball Injuries in Older Adults” by Baylor College of Medicine is an excellent article. The sports medicine experts give a very thorough explanation of what they see most, which is shoulder injuries. They explain how they happen and review the best treatment plans. As I learned from Erin Erb, PT, MS guide called Shoulder Girdle Stabilization, “The shoulder joint is the most mobile joint in the body and also the least stable.”

It’s not until the end of the article that you see the other three most common types of pickleball injuries. So, I will give you the complete list of all four below. Plus, I’ve highlighted the area of the body where these types of injuries would occur.

  1. Rotator cuff tendons: shoulder.
  2. Meniscus tears: knee.
  3. Tendon ruptures: Achilles, around the knee, bicep, or shoulder.
  4. Aggravation of arthritic knees (can cause pain and swelling). 

Although the article mentions the importance of doing warm-ups, stretches, maintaining flexibility, and improving muscle/joint strength, it is short on specifics. Being a personal trainer who specializes in working with older adults, I’m happy to cover the warm-ups and stretches I use to help keep my clients injury free. I’ll also review the best way seniors can maintain flexibility and muscle/joint strength.

Don’t Skip The Warm-Ups

Warming up before you exercise is so important to prevent injuries. It should be a full-body warm-up that slowly increases the heart rate to increase blood and oxygen circulation. This helps the muscles to be more flexible and lubricates the joints so they move more freely. This decreases the risk of a tear, sprain, or strain. A warm-up should last anywhere from 5-10 minutes. If the air temperatures are cool or you have a lot of joint stiffness, you should consider warming up longer or enough to start feeling warm and more flexible.

Here is a full body warm-up sequence I frequently use when training seniors.

Begin with a slow walk for 1-2 minutes. Add alternating arms swings, front to back. As you begin feeling more flexible, walk faster and make bigger arms swings. Moving legs and arms together help increase the heart rate and increase blood and oxygen flow. Here is the rest of the warm-up/stretching sequence:

  • Knees/hip warm-ups: Try doing high knee marches, a light jog, (both can be done in place), or shallow air squats. Add arm circles, arm swings, alternating overhead arm reaches, or front punches. Repeat your choice of knee/hip warm-up for at least 1 minute.
  • Torso/back stretches: Stand with feet shoulder-width apart, reach the right arm across the body past the left shoulder, slightly rotating in the torso. Hold for a two-count, and come back to the center. Using the left arm, reach past the right shoulder, holding for a two-count. Repeat, alternating arms reach to each side for at least 1 minute (this stretch can also be done by reaching straight above the head instead of reaching across the body).
  • Shoulder warm-ups: Stand with feet shoulder-width apart. Lean forward by hinging at the hips. Totally relax one arm and shoulder. Pretend you’re stirring a big pot and rotate the arm/shoulder clockwise for 6-8 stirs. Reverse and go counterclockwise with the same arm. Switch arm/shoulder and repeat. This is an excellent warm-up for the rotator cuff. Caution, don’t lean forward or hinge past a 45 degree angle.
  • Ankle warm-ups: Sit or stand while holding on and rotate each ankle clockwise then counterclockwise 6-8 times each. Then point and flex each foot 6-8 times each. This also helps warm up the Achilles tendon.
  • Wrist warm-ups: Interlock the fingers together and draw big horizontal figure eights, 10-12 times moving the wrists freely.
  • Hand/grip warm-ups: Start with palms facing up, spread the fingers wide, make a tight fist, and open while spreading fingers wide again. Repeat 6-8 times. Then, turn hands with palms facing down and repeat spreading the fingers and making a tight fist for another 6-8 times.
  • Elbow warm-ups: While standing, feet shoulder width apart, make a fist, and move arms up and down to imitate a bicep curl, keeping arms close to your side. Repeat the curls 10-12 times. 

Pro Tip: As you’re performing the warm-ups, practice good posture to help improve lung capacity and keep joints and muscles in better alignment. This will help decrease your risk of injuries overall and improve your balance for your activities.

Give Your Body A Chance To Adapt

When starting with pickleball — or any new sport — I can’t emphasize enough how important it is to start slowly. The first day is not the time to jump in for a full hour long (or more) of play. Even if you’ve been playing tennis and switching to pickleball, it’s important to give your body a chance to adapt. Try playing just one game or perhaps play for 15-20 minutes. Do this for the first week or at least three consecutive outings. Gradually adding more playing time. This will help you prevent pain and soreness from the muscles being overused as well as prevent an injury.

Don’t Skip The Cool Down And Stretches

Adding a cooldown and stretches after your workout is just as important as the warm-up. For a cool down, the objective is to get your heart rate back to normal to prevent the blood from pooling in your limbs which could cause dizziness. A slow walk works perfectly.

Stretches are meant to increase flexibility, relieving the tension on the joints thus preventing tightness, stiffness, or soreness after play. Any of the warm-up exercises I’ve included could also be used as stretches or you can check out the “8 Relaxing Total Body Stretches” from Verywell Fit.

Pro Tip: Stretching is also strengthening the muscles. It helps increase the blood and oxygen flow through the tissues which may help prevent swelling in arthritic joints.

Keep Muscles And Joints Strong

The strength of your muscles and joints does play an important part in preventing injuries. Although most people instantly think of lifting weights, there are actually lots of other ways to improve muscle strength. Exercise programs or classes that work the full body will be the most beneficial.

Tai Chi, Yoga, Pilates, or Barre classes will build strength. Resistance bands or suspension training (TRX) builds strength. These forms of strength training programs are easier on joints than regular weight lifting with dumbbells or barbells. Weight machines are an option if you belong to a gym or Y that has them. To get the most benefit, have a trainer go over (or review) the proper way to use the machines.

Hire a personal trainer who specializes in fitness for seniors or see if your friends want to get together and have their own private small group personal training sessions. As our grandmothers used to tell us, “an ounce of prevention is worth a pound of cure.”

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